Dibb Bridget, Yardley Lucy
University of Southampton, Southampton, Hampshire SO17 1BJ, UK.
Soc Sci Med. 2006 Sep;63(6):1602-13. doi: 10.1016/j.socscimed.2006.03.031. Epub 2006 May 22.
Despite the growing popularity of self-help groups for people with chronic illness, there has been surprisingly little research into how these may support adjustment to illness. This study investigated the role that social comparison, occurring within a self-help group, may play in adjustment to chronic illness. A model of adjustment based on control process theory and response shift theory was tested to determine whether social comparisons predicted adjustment after controlling for the catalyst for adjustment (disease severity) and antecedents (demographic and psychological factors). A sample of 301 people with Ménière's disease who were members of the Ménière's Society UK completed questionnaires at baseline and 10-month follow-up assessing adjustment, defined for this study as functional and goal-oriented quality of life. At baseline, they also completed measures of the predictor variables i.e. the antecedents (age, sex, living circumstances, duration of self-help group membership, self-esteem, optimism and perceived control over illness), the catalyst (severity of vertigo, tinnitus, hearing loss and fullness in the ear) and mechanisms of social comparison within the self-help group. The social comparison variables included the extent to which self-help group resources were used, and whether reading about other members' experiences induced positive or negative feelings. Cross-sectional results showed that positive social comparison was indeed associated with better adjustment after controlling for all the other baseline variables, while negative social comparison was associated with worse adjustment. However, greater levels of social comparison at baseline were associated with a deteriorating quality of life over the 10-month follow-up period. Alternative explanations for these findings are discussed.
尽管慢性病患者自助小组越来越受欢迎，但令人惊讶的是，关于这些小组如何支持患者适应疾病的研究却很少。本研究调查了自助小组内发生的社会比较在慢性病适应过程中可能发挥的作用。基于控制过程理论和反应转移理论的适应模型进行了测试，以确定在控制了适应的催化剂（疾病严重程度）和前因（人口统计学和心理因素）后，社会比较是否能预测适应情况。301名患有梅尼埃病的英国梅尼埃病协会成员作为样本，在基线和10个月随访时完成了问卷，评估适应情况，本研究将其定义为功能和目标导向的生活质量。在基线时，他们还完成了预测变量的测量，即前因（年龄、性别、生活环境、自助小组成员资格持续时间、自尊、乐观主义和对疾病的感知控制）、催化剂（眩晕、耳鸣、听力损失和耳内胀满的严重程度）以及自助小组内社会比较的机制。社会比较变量包括使用自助小组资源的程度，以及阅读其他成员的经历是否会引发积极或消极情绪。横断面结果表明，在控制了所有其他基线变量后，积极的社会比较确实与更好的适应相关，而消极的社会比较则与更差的适应相关。然而，基线时更高水平的社会比较与10个月随访期间生活质量的恶化相关。对这些发现的其他解释进行了讨论。
